PACS:
1. n. (acronym)Picture Archiving and Communications System. A device or group of devices and associated network components designed to store and retrieve medical images.
2. n. (acronym)Pain And Constant Suffering.

Thursday, August 16, 2012

More Thunder And A Bigger Blunder Down Under?

I received this comment just today, referencing my Western Australia posts. As usual, the source remains anonymous although I can confirm that the comment originates from within Oz.

Once again, we Americans are behooved to reconsider just how much control we should allow our government to have over our health care and our very lives...

Dr Dalai, this information seems very similar to issues that we consistently hear about from radiologists reporting on the RIS/PACS at QLD Health. The Western Australia PACS issues seem to have similar characteristics to the issues in QLD we so often hear grumbles about.
Your call for help on behalf of the Western Australia Health Department’s seemingly beleaguered PACS may not be receiving the attention it deserves. The reason is probably because the vendor is busy trying to fix the problems in QLD which have apparently been present since 2006! Wow, six years and a half years, now that is unbelievable and I may suggest the reason why the WA issue resolution may have stalled for some time.

It is easy to point the finger without knowing the intricate details of the solution architecture. I doubt discussion papers have been published for the public to read and facilitate better understanding of the problems and how they are being addressed, in addition to budget estimates and timelines. Again, these complex IT projects seem to fall into a void which lacks transparency, when they need it most.

Both Western Australia Health and Queensland Health seem to have embarked on a courageous mission to rollout a single solution across the entire state. What may have seemed to be a great idea at the time has turned out to be a nightmare in the two geographically largest states in Australia.

It all started with an idea and a sales pitch, and unfortunately WA and QLD Health did not think to prove out the idea first before trying to roll it out across every hospital in the two largest states in Australia. Instead of fixing the initial issues they seem to have continued rolling out these failed ideas, thus creating further problems and requiring further public investment. Governance and accountability went into hiding. We should be asking the Government to publish the business cases behind the further investment in these failed ideas and requesting independent experts to review them.

In both situations the idea seems to have failed miserably and has cost the tax payer 100s millions of dollars and there does not seem to be any accountability. Who were the decision makers? Who is responsible for fixing the current problems? Is there an exit strategy or do we continue to throw more public funds at an idea which simply doesn’t work and continue to risk public investment to the point where the Government initiative ends up in the same situation as the Victorian Government’s botched Healthsmart program?

Looking at the media recently surrounding QLD Health, I doubt it can afford another payroll debacle – the payroll system was initially costed at $250M and is now expected to cost the taxpayer $1.2 Billion, wow. Again, the theme seems to be one of throwing more public investment into an idea which didn’t work before, doesn’t work now and.......
There are large amounts of Federal and State eHealth funds flowing around Australia, but there seems to be a lack of accountability and governance. We have public servants running around making rash decisions about complex technology projects which need better analysis.

We can’t wait till later. It is all happening now. The public does not seem to impose the same level of scrutiny around these eHealth initiatives, might I suggest because they are health care related and we intrinsically feel that we are impeding the health of fellow citizens if we question this waste of public funds?

These complex projects need to be independently reviewed now, not later. Have we learnt any lessons from previous failed eHealth programs? I think not. If we continue along this trajectory we run this risk of not getting the return on investment we should be getting as a nation – never forget that the “bang for the buck” is very important when it involves public funds and/or corporate projects.

1 comment
:

yeah my PACS guru buddy & I were shakin our heads the other day talking about the WA situation...sad sadDoesn't it seem sometimes that the sheer size and scope of govt makes it feel futile to the average jo to have any voice, or demand some measure of accountability?It's like, once these giant cogs get to turning, and millions of bucks are woven into the fabric of a system, it's like who can track down where it all goes?